Researchers Propose Extending Diabetic Retinopathy Screening Interval

By Amy Orciari Herman

Edited by Richard Saitz, MD, MPH, FACP, DFASAM

A research group proposes extending the screening interval for diabetic retinopathy in low-risk patients with type 1 diabetes. Currently, annual exams are recommended.

The researchers followed 1400 people with type 1 diabetes for nearly 30 years. Fundus photography was performed every 6 months during for the first 10 years, then every 4 years thereafter. Some 24,000 retinopathy examinations were performed.

Changes in patients' exam results were analyzed throughout follow-up to estimate the odds of progression to proliferative diabetic retinopathy. Based on their findings, the researchers suggest the following screening schedule according to a patient's retinopathy state:

• State 1 — no retinopathy — screen every 4 years

• State 2 — mild nonproliferative retinopathy — every 3 years

• State 3 — moderate nonproliferative retinopathy — every 6 months

• State 4 — severe nonproliferative retinopathy — every 3 months

Increasing glycated hemoglobin levels would warrant more frequent screening.

In the New England Journal of Medicine, the authors say their screening schedule would save $1 billion over 20 years. Editorialists, meanwhile, note that the schedule could lower screening rates too much.